A prospective longitudinal approach to examine the association between social position in childhood, adolescence, and adulthood with the control of hypertension during adulthood.

Introduction: Hypertension is one of the main concerns in public health, since it is related with increased morbidity, and potential years of life lost in addition to loss of quality of life. This study aimed to assess: (1) the distribution of indicators of life course SEP in a cohort of Colombian patients with hypertension and (2) to assess the association of life course SEP and control of hypertension among this cohort of patients. Methods: Data were obtained using the baseline survey of 258 patients from the Social Determinants and Inequities in the Control of Blood Hypertension Program (ProDSICHA). Mother occupation and housing conditions were measured with the Event History Calendar. Mother educational level was measured with the questionnaire developed by the Project on Ethnicity and Race in Latin America (PERLA). Socioeconomic position during adulthood was measured using education, occupation, and income level based in the MacArthur Network. Results: The group with a higher lifelong social position and the group of lower lifelong social position showed better control of hypertension (OR = 1.21; p <0.05; OR = 1.33; p < .05, respectively) compared to those whose social position throughout life varied the most. No statistical differences were found in the relations between single lifetime social position variables, and hypertension control in the three time points analyzed. Discussion: These findings warrant further research to deeper our understanding on the role of a multidimensional and cumulative approach of social position in hypertension control.

Built environment interventions and physical activity levels: A systematic review. / Intervenciones en el ambiente construido y niveles de actividad física: una revisión sistemática

INTRODUCTION: Non-communicable diseases are the leading cause of death worldwide and physical activity is a key preventive strategy to reduce them. There is a relationship between the built environment and the practice of physical activity, but little evidence as to whether those built environment interventions not initially designed for promoting physical activity actually have an impact on promoting the behavior. OBJECTIVE: To identify whether such built environment interventions were able to change physical activity in adults. MATERIALS AND METHODS: We conducted a systematic review of interventions targeting modifications to the built environment changes in urban areas. RESULTS: Out of 5,605 articles reviewed, only seven met our inclusion criteria. The seven studies found higher levels of physical activity after the interventions. CONCLUSIONS: We recommend greater specificity regarding the study design, the timeline of interventions implementation and post-intervention measurements, as well as the use of more objective measures. Finally, we point out the need to make more explicit the mechanisms of change related to the interventions assessed.

Introducción. Las enfermedades no transmisibles son la principal causa de muerte en todo el mundo y la actividad física es una estrategia preventiva clave para reducirlas. Hay una relación entre el entorno construido y la práctica de actividad física, pero poca evidencia de si las intervenciones no diseñadas en principio para promoverla, realmente tienen un impacto en ese sentido. Objetivo. Determinar si tales intervenciones en el entorno urbano pudieron cambiar la práctica de actividad física en adultos. Materiales y métodos. Se hizo una revisión sistemática de las intervenciones que apuntaban a modificar el entorno construido en zonas urbanas. Resultados. De 5.605 artículos considerados, solo siete cumplieron con nuestros criterios de inclusión y en todos ellos aumentó la actividad física después de la intervención. Conclusiones. Se recomienda que el diseño del estudio, el cronograma de implementación de las intervenciones y las mediciones posteriores sean más específicas, de manera que las medidas obtenidas sean más objetivas. Asimismo, se argumenta la necesidad de hacer más explícitos los mecanismos de cambio relacionados con las intervenciones evaluadas.

Built environment interventions and physical activity levels: A systematic review / Intervenciones en el ambiente construido y niveles de actividad física: una revisión sistemática

Introduction: Non-communicable diseases are the leading cause of death worldwide and physical activity is a key preventive strategy to reduce them. There is a relationship between the built environment and the practice of physical activity, but little evidence as to whether those built environment interventions not initially designed for promoting physical activity actually have an impact on promoting the behavior. Objective: To identify whether such built environment interventions were able to change physical activity in adults. Materials and methods: We conducted a systematic review of interventions targeting modifications to the built environment changes in urban areas. Results: Out of 5,605 articles reviewed, only seven met our inclusion criteria. The seven studies found higher levels of physical activity after the interventions. Conclusions: We recommend greater specificity regarding the study design, the timeline of interventions implementation and post-intervention measurements, as well as the use of more objective measures. Finally, we point out the need to make more explicit the mechanisms of change related to the interventions assessed.

Introducción. Las enfermedades no transmisibles son la principal causa de muerte en todo el mundo y la actividad física es una estrategia preventiva clave para reducirlas. Hay una relación entre el entorno construido y la práctica de actividad física, pero poca evidencia de si las intervenciones no diseñadas en principio para promoverla, realmente tienen un impacto en ese sentido. Objetivo. Determinar si tales intervenciones en el entorno urbano pudieron cambiar la práctica de actividad física en adultos. Materiales y métodos. Se hizo una revisión sistemática de las intervenciones que apuntaban a modificar el entorno construido en zonas urbanas. Resultados. De 5.605 artículos considerados, solo siete cumplieron con nuestros criterios de inclusión y en todos ellos aumentó la actividad física después de la intervención. Conclusiones. Se recomienda que el diseño del estudio, el cronograma de implementación de las intervenciones y las mediciones posteriores sean más específicas, de manera que las medidas obtenidas sean más objetivas. Asimismo, se argumenta la necesidad de hacer más explícitos los mecanismos de cambio relacionados con las intervenciones evaluadas.

Socioeconomic position and quality of life among Colombian hypertensive patients: The mediating effect of perceived stress.

This study aimed to assess the relationships between socioeconomic position, perceived stress and Health Related Quality of Life (HRQoL) of patients with hypertension. Data were obtained using the baseline survey of 258 patients from the Social Determinants and Inequities in the Control of Blood Hypertension Program (ProDSICHA). HRQoL was measured with SF-8 Health Survey. Socioeconomic position was measured using education, and the MacArthur Scale. Stress was measured with Perceived Stress Scale. A higher educational level was associated with a higher perception of stress (Coeff = 0.78, p = 0.019). Also, a lower position in the community was associated with a higher perception of stress (Coeff = -0.56, p = 0.027). A higher level of perceived stress was associated with a higher level of mental health (Coeff = 0.64, p = 0.000). No statistical differences were found in the relations between socioeconomic position and physical HRQoL. These findings warrant further research to understand the role of socioeconomic position in physical HRQoL.

Evolution of Resting Energy Expenditure, Respiratory Quotient, and Adiposity in Infants Recovering from Corrective Surgery of Major Congenital Gastrointestinal Tract Anomalies: A Cohort Study.

This cohort study describes the evolution of resting energy expenditure (REE), respiratory quotient (RQ), and adiposity in infants recovering from corrective surgery of major congenital gastrointestinal tract anomalies. Energy and macronutrient intakes were assessed. The REE and RQ were assessed by indirect calorimetry, and fat mass index (FMI) was assessed by air displacement plethysmography. Longitudinal variations over time are described. Explanatory models for REE, RQ, and adiposity were obtained by multiple linear regression analysis. Twenty-nine infants were included, 15 born preterm and 14 at term, with median gestational age of 35.3 and 38.1 weeks and birth weight of 2304 g and 2935 g, respectively. In preterm infants, median REE varied between 55.7 and 67.4 Kcal/kg/d and median RQ increased from 0.70 to 0.86-0.92. In term infants, median REE varied between 57.3 and 67.9 Kcal/kg/d and median RQ increased from 0.63 to 0.84-0.88. Weight gain velocity was slower in term than preterm infants. FMI, assessed in a subset of 15 infants, varied between a median of 1.7 and 1.8 kg/m2 at term age. This low adiposity may be related to poor energy balance, low fat intakes, and low RQ¸ that were frequently recorded in several follow-up periods.

Differences between leisure-time physical activity, health-related quality of life and life satisfaction: Al Ritmo de las Comunidades, a natural experiment from Colombia.

Physical inactivity is one of the major public health problems worldwide. Community-based interventions have been pointed out as a promising strategy to increase physical activity (PA) levels and impact population health. Recreovía is a community program with a potential to promote PA. There is growing evidence for two benefits derived from the practice of PA: an increased perception of health-related quality of life (HRQoL) and life satisfaction (LS). The purpose of this study was to assess differences between leisure-time PA and perceptions of both HRQoL and LS, as well as to assess differences between perceptions of both HRQoL and LS for Recreovía and non-Recreovía participants. Data were obtained using the baseline cross-sectional survey of 1533 participants (501 belonged to the intervention group) as part of the natural experiment Al Ritmo de las Comunidades. HRQoL was measured with the European Organization for Research and Treatment of Cancer 30-item questionnaire, LS was measured with Questions on Life Satisfaction Scale, and self-reported minutes of leisure-time PA were measured with the long version of the International Physical Activity Questionnaire. The mean age of participants was 41.7 years (standard deviation (SD) = 16.3). The participants had a good overall HRQoL and LS. The mean minutes of leisure-time PA were 158.1 min (SD = 230.2) a week. Results showed that those participants who reported higher leisure-time PA levels also reported a significantly higher LS (M = 41.9, SD = 35.0) relative to participants with lower levels (M = 37.6, SD = 34.2, t(1532) = -2.36, p < 0.01). There were no statistical differences in the perception of HRQoL and leisure-time PA (t(1532) = -1.03, p = 0.30), although active people had higher scores. Both HRQoL and LS scores were higher in individuals who were participating in Recreovía (p < 0.001). Higher LS scores were found in the group with higher leisure-time PA, while HRQoL showed no differences. Better psychological well-being indices were found in the Recreovía group.

Quality of life in breast cancer patients: Associations with optimism and social support.

Background/Objective: The purpose of this study was to examine quality of life (QoL) in breast cancer patients from Colombia and to explore the relationship between QoL, habitual optimism, and social support. Method: A sample of 95 breast cancer patients treated in a hospital in Bogotá were administered the QoL instrument EORTC QLQ-C30 and the Life Orientation Test LOT-R. Additionally, they were asked to indicate from whom (physicians, friends, nurses, etc.) they wished and received social support. Reference data for the EORTC QLQ-C30 and the LOT-R were taken from a representative sample of the general Colombian population. Results: The breast cancer patients showed detriments to their QoL on most functioning scales and symptom scales of the EORTC QLQ-C30, while their general assessments of health and QoL were not worse than those of the controls. Optimism was positively correlated with QoL. Most patients wanted and received social support from their physicians and friends/family. Conclusions: The results suggest that optimism helps patients better cope with disease. A general assessment of global QoL cannot replace the more specific assessments of the functioning domains and symptoms.

Antecedentes/Objetivo: El objetivo del estudio fue examinar la calidad de vida (QoL, por sus siglas en inglés) en pacientes con cáncer de mama colombianas, y explorar la asociación entre calidad de vida, optimismo disposicional y apoyo social. Método: Se entrevistó una muestra de 95 pacientes con cáncer de mama tratadas en un hospital de Bogotá y les fue aplicado el instrumento de medición de calidad de vida EORTC QLQ-C30 y el test de orientación ante la vida (LOT-R). Adicionalmente, se preguntó acerca de su apoyo social usando varias preguntas. Resultados: En la mayoría de las escalas de funcionamiento del EORTC QLQ-C30 y de las escalas de síntomas, las pacientes con cáncer mostraron detrimentos en su QoL, mientras en la evaluación general de calidad de vida y salud las medias de las pacientes no fueron más bajas que las de los controles. El optimismo estuvo positivamente correlacionado con la calidad de vida. La mayoría de las pacientes desearon y recibieron apoyo social de su médico y de sus amigos/familiares. Conclusiones: Los resultados sugieren que el optimismo ayuda a las pacientes a afrontar mejor la enfermedad. Una evaluación general de la QoL no parece poder sustituir la evaluación más específica de los síntomas y dominios de funcionamiento.

Quality of life in breast cancer patients: Associations with optimism and social support / Calidad de vida en pacientes con cáncer de mama: asociación con optimismo y apoyo social

Background/Objective: The purpose of this study was to examine quality of life (QoL) in breast cancer patients from Colombia and to explore the relationship between QoL, habitual optimism, and social support. Method: A sample of 95 breast cancer patients treated in a hospital in Bogotá were administered the QoL instrument EORTC QLQ-C30 and the Life Orientation Test LOT-R. Additionally, they were asked to indicate from whom (physicians, friends, nurses, etc.) they wished and received social support. Reference data for the EORTC QLQ-C30 and the LOT-R were taken from a representative sample of the general Colombian population. Results: The breast cancer patients showed detriments to their QoL on most functioning scales and symptom scales of the EORTC QLQ-C30, while their general assessments of health and QoL were not worse than those of the controls. Optimism was positively correlated with QoL. Most patients wanted and received social support from their physicians and friends/family. Conclusions: The results suggest that optimism helps patients better cope with disease. A general assessment of global QoL cannot replace the more specific assessments of the functioning domains and symptoms (AU)

Antecedentes/Objetivo: El objetivo del estudio fue examinar la calidad de vida (QoL, por sus siglas en inglés) en pacientes con cáncer de mama colombianas, y explorar la asociación entre calidad de vida, optimismo disposicional y apoyo social. Método: Se entrevistó una muestra de 95 pacientes con cáncer de mama tratadas en un hospital de Bogotá y les fue aplicado el instrumento de medición de calidad de vida EORTC QLQ-C30 y el test de orientación ante la vida (LOT-R). Adicionalmente, se preguntó acerca de su apoyo social usando varias preguntas. Resultados: En la mayoría de las escalas de funcionamiento del EORTC QLQ-C30 y de las escalas de síntomas, las pacientes con cáncer mostraron detrimentos en su QoL, mientras en la evaluación general de calidad de vida y salud las medias de las pacientes no fueron más bajas que las de los controles. El optimismo estuvo positivamente correlacionado con la calidad de vida. La mayoría de las pacientes desearon y recibieron apoyo social de su médico y de sus amigos/familiares. Conclusiones: Los resultados sugieren que el optimismo ayuda a las pacientes a afrontar mejor la enfermedad. Una evaluación general de la QoL no parece poder sustituir la evaluación más específica de los síntomas y dominios de funcionamiento (AU)

Fatigue in the general population of Colombia - normative values for the multidimensional fatigue inventory MFI-20.

BACKGROUND: Fatigue is a frequent symptom in cancer patients. In Europe and Northern America fatigue questionnaires were developed and tested, but their generalizability to other cultural contexts is largely unknown. The aim of this study is to provide normative values for the Multidimensional Fatigue Inventory (MFI-20) based on a representative sample of the general population in Colombia and to test psychometric properties. METHODS: 1,500 individuals completed a questionnaire that contained the MFI-20, as well as other questionnaires, and questions on sociodemographic variables and chronic diseases. RESULTS: The mean values of the scales were marginally higher than those for 2 European samples. The mean value of the total score was 44.3 ± 14.1. Women were affected by fatigue more than men, and there was an almost linear age trend, with higher mean scores for older subjects. People with chronic diseases were affected by fatigue more than people without chronic conditions. The best psychometric properties were obtained for the total scale (sum score) of the MFI-20. CONCLUSION: The normative values presented here can help us to assess the individual burden of fatigue in a Latin American context. Psychometric properties of the MFI-20 in Colombia are similar to those obtained in Europe.

Physical activity, nutrition and behavior change in Latin America: a systematic review.

Physical activity (PA) and nutrition are key health behaviors underlying the design and implementation of prevention strategies for non-communicable diseases (NCDs) in Latin America. Nevertheless, research still reports low prevalence of PA and fruit and vegetable consumption throughout the region. This paper aims at reviewing the ways in which models of behavior change theory have been applied in study development and implementation regarding nutrition and PA in Latin America. In August 2011 we conducted a systematic literature review of the behavior change studies that targeted such NCDs risk factors published until then. Out of 4279 surveyed abstracts, only 29 corresponded to articles that met our inclusion criteria. Twenty-six articles reported the application of behavior change theory, with the trans-theoretical model (n = 12) being the most frequently used. Other theories and models included the socio-ecological model (n = 4), cognitive theory (n = 3), social cognitive theory (n = 2) and theories related to health education and counseling (n = 5). Based on this review, we recommend that the application of behavior change theory be explicitly reported in Latin American peer-reviewed articles, and that outcome evaluations include behavior change constructs so as to better assess their contribution to the effectiveness of nutrition and PA interventions in the region. Furthermore, we state the need for a better understanding of the behavior change mechanisms that may be specific to the Latin American context.

Cuando el cáncer de seno no significa insatisfacción sexual. Un estudio comparativo / No disponible

El cáncer de seno es considerado un problema de salud pública, en la medida en que actualmente se presenta como uno de los factores más comunes de morbimortalidad en mujeres de países de todo el mundo, y de Colombia. Aunque se haya verificado un aumento importante en el número de sobrevivientes de cáncer de seno, la vivencia de esta enfermedad puede comprometer aspectos relacionados con la sexualidad, lo que implica atribuir mayor relevancia a los procesos de adaptación psicosocial, y a su impacto en la calidad de vida de estas mujeres. Este estudio busca evaluar los niveles de satisfacción sexual de pacientes con cáncer de seno. Para esto, se recolectaron datos de 100 mujeres sanas y de 84 pacientes con diagnóstico de cáncer de seno, en un hospital universitario en la ciudad de Bogotá. Se aplicó el Index of Sexual Satisfaction (ISS) y el Suplementary Questionnaire Breast Cancer Module (EORTC, QLQ BR-23). Los resultados mostraron que existen diferencias significativas en el nivel de insatisfacción sexual en los dos grupos (t(156)=9,33, p<0,001), pero contrario a lo que se esperaba, las pacientes se encuentran menos insatisfechas con su sexualidad (M=24,6, SD=17,5), en comparación con el grupo de mujeres sanas (M=46,9, SD=12,4). Los tratamientos que más se asocian con la insatisfacción sexual son la radioterapia (M=26,2, SD=16,6) y la terapia hormonal (M=26,3, SD=16,8) pero los resultados no fueron estadísticamente significativos. El disfrute (r=-0,542, p=0,01), el interés en el sexo (r=-0,285, p=0,015) y la vida sexual activa (r=-0,240, p=0,04) parecen ser aspectos protectores en cuanto al nivel de satisfacción sexual en las mujeres. El proceso de ajuste a la enfermedad puede variar de acuerdo a las características de la paciente, de la enfermedad, y del trascurso de la misma, lo que lleva a concluir que un diagnóstico de esta naturaleza es de carácter multidimensional. Asimismo, la reinterpretación de los acercamientos entre la pareja, el ofrecimiento de apoyo y la valoración de la relación como satisfactoria, pueden mediar la interpretación de la vida sexual. Más allá de los aspectos físicos presentes en el nivel de satisfacción sexual, existen otros aspectos de orden emocional que pueden llegar a predecir la satisfacción reportada por la persona (AU)

Breast cancer is currently considered a public health problem, since it is one of the most common factors of morbidity and mortality in women in countries around the world, and also in Colombia. Although there has been an increase in the number of breast cancer survivors, the experience of the disease may compromise sexuality aspects, which highlights the importance of the process of psychological adaptation, and its impact on the quality of life of these women. This study aims to assess the levels of sexual dissatisfaction in patients with breast cancer. For this purpose, 100 healthy women were interviewed and their answers were compared to those of 84 patients diagnosed with breast cancer, contacted through a university hospital in Bogotá. The Index of Sexual Satisfaction (ISS) and the Supplementary Questionnaire Breast Cancer Module (EORTC QLQ BR-23) were applied. The results showed significant differences in the level of sexual dissatisfaction in both groups (t(156)= 9.33, p<0.001), where the group of patients was less dissatisfied with their sexuality (M=24.6, SD=17.5), compared with the group of healthy women (M=46.9, SD=12.4). The treatments that are mostly associated with sexual dissatisfaction are (AU)